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First evidence for occurrence of exercise oscillatory ventilation in a general population at cardiovascular risk: insights from the EURO(pean) EX(ercise) population-based study

Session Poster Session III - Friday 08:30 - 12:30

Speaker Marco Guazzi

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Risk Factors and Prevention
  • Session type : Poster Session

Authors : M Pellegrino (San Donato M.se,IT), G Generati (San Donato M.se,IT), F Bandera (San Donato M.se,IT), V Donghi (San Donato M.se,IT), V Labate (San Donato M.se,IT), E Alfonzetti (San Donato M.se,IT), M Gaeta (Pavia,IT), O Ferraro (Pavia,IT), S Villani (Pavia,IT), M Guazzi (San Donato M.se,IT)

Authors:
M Pellegrino1 , G Generati1 , F Bandera1 , V Donghi1 , V Labate1 , E Alfonzetti1 , M Gaeta2 , O Ferraro2 , S Villani2 , M Guazzi1 , 1IRCCS Policlinico San Donato, Heart Failure Unit - San Donato M.se - Italy , 2University of Pavia, Unit of Biostatistics and Clinical Epidemiology - Pavia - Italy ,

Citation:

Background: Cardiopulmonary exercise testing (CPET) allows functional evaluation of cardiopulmonary diseases. Among CPET variables, exercise oscillatory ventilation (EOV) identifies heart failure patients with worse prognosis, but the occurrence is not described in literature in the general population at risk for cardiovascular (CV) diseases without previous CV events. We aimed at assessing the prevalence of EOV in a general population enrolled in the EUROEX study. Methods: 557 healthy subjects (age 60±14 years; male 51%) underwent maximal CPET  (personalized incremental ramp protocol). A subgroup (n=205) also underwent rest echocardiography.
Results: A prevalence of 16% EOV was observed. The EOV group showed higher prevalence of diabetes (n=24, 25% vs n=67, 14%; p<.05) and female sex(n=69, 75% vs n=216, 47%; p<.05); an impaired exercise tolerance, of all VO2-related variables (peak VO2 and % of predicted VO2, O2 pulse, VO2@AT) and ventilator efficiency; a lower heart rate (HR) at peak exercise and heart rate recovery (HRR). Echocardiographic data showed a reduction of end-systolic dimensions of both ventricles and right atrial area in the EOV Group (n=41 vs n=164). At a multivariate analysis the EOV determinants were: TAPSE (OR: 0.16; p: 0.03); E/A (OR: 0.07; p: 0.04); BMI (OR: 1.12; p: 0.09).
Conclusion: EOV patients exhibited a higher prevalence of diabetes,  worse exercise performance and ventilation efficiency. These findings may provide the bases for a more in-depth prediction of CV risk.

Variables

EOV (n=93)

No EOV (n=464)

P Value

Age, y

64±13

59±14

<.01

BMI, kg/m2

33±7

29±5

.07

Peak VO2, ml/kg/min

15.1±3.8

20±7.2

<.01

Peak O2 pulse, ml/beat

9.6±3

11.3±3.8

<.01

VE/VCO2 slope

27.7±4.6

25.7±3.6

<.01

Peak HR, bpm

125±21

135±23

<.01

HRR, beats

14±9

16±9

<.05

LV end-systolic volume index, ml/mq

13.5±4

15.5±6

<.05

Right atrial area, cmq

14.8±4

16.8±4

<.01

RV end-systolic area, cmq

6.9±1.6

7.8±2

.01

TAPSE, mm

23.6±3

25.2±4

.07

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